Contract Pharmacy Details

CAREMARK TENNESSEE SPECIALTY PHARMACY, L
CHC10607-01 COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC

Covered Entity Details

Entity Name

COMPREHENSIVE COMMUNITY HEALTH CENTERS, INC

Subdivision Name

Comprehensive Community Health Centers, Inc-Highland Park

Type

HRSA-Funded Health Center

340B ID

CHC10607-01

Entity Address

5059 York Blvd
Los Angeles, CA 90042-1713

Grant Number

H80CS10607

Participating Start Date

1/1/2005

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

CAREMARK TENNESSEE SPECIALTY PHARMACY, L

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
8370 WOLF LAKE DR
STE 107
BARTLETT, TN 38133

Pharmacy Comments

Contract Details

Approval Date

7/17/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

FLORA POLADYAN, COO
(818) 630-6106

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/17/2024

340B Drug Pricing Program Database